Neurovascular diseases – Christina Sjöstrand's research group

We study the relationships between stroke, headache and cardiac conditions. We manage large patient volumes with migraine, drive the development of migraine care and initiate treatment trials. and explore neurological symptoms following cardiac interventions in collaboration with Danderyd Hospital.

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The research Group Neurovascular Diseases, led by Christina Sjöstrand, conducts clinical and translational research into stroke, migraine, PFO, cardiac interventions and genetic disorders affecting small blood vessels.

We work with large numbers of migraine patients and initiate studies on treatment outcomes. Our collaborations span neurogenetics, insurance medicine, cardiology and stroke treatment.

The research encompasses clinical cohorts, registry data, biomarkers and genetic analyses, with the aim of improving the diagnosis, risk stratification and treatment of neurovascular diseases.

Our research

Neurovascular diseases – Research at the interface between the heart, blood vessels and the brain

Stroke is one of the most common causes of death and long-term disability worldwide. Around 85 per cent of strokes are ischaemic and 15 per cent are caused by cerebral haemorrhage.

Despite advances in thrombolysis and thrombectomy, significant gaps in knowledge remain regarding the underlying mechanisms and the interaction between cardiac and cerebrovascular factors.

A quarter of all ischaemic strokes are cryptogenic, and approximately half of these patients have a patent foramen ovale (PFO), which is also known to be more common in people with migraine with aura.

Stroke is also the best-studied neurological complication following cardiac surgery, but other peri- and post-operative neurological symptoms remain poorly characterised.

Patients and cardiologists often report transient or aura-like symptoms following cardiac interventions, but these are rarely documented systematically. This discrepancy between clinical experience and research data warrants further investigation.

As one of the country’s largest cardiology departments, Danderyd Hospital offers unique conditions for such projects.

Research areas

Stroke, TIA and cardiac interventions

We are investigating how atrial fibrillation, PFO and other cardiac sources of embolism affect the risk of TIA, ischaemic stroke and transient neurological symptoms in connection with cardiac interventions. The research is based on clinical data, imaging, biomarkers and prospective studies, carried out in close collaboration with Danderyd Hospital.

Sara Jadidi is a PhD student on the project 'Heart and brain – Studies of cardiac intervention, atrial fibrillation, PFO and their relationship to TIA and stroke’.

Ischaemic stroke in working-age adults

Mihae Roland completed her PhD with a thesis entitled ‘Ischaemic stroke in working-age adults: large vessel occlusion, work capacity and outcome after thrombectomy’ and is now studying work capacity, return to work and long-term functional outcomes in collaboration with Professor Kristina Alexanderson at the Department of Insurance Medicine.

Headaches, stroke and cardiac links

The research group has extensive experience of working on migraine, particularly migraine with aura, and its link to cerebrovascular risk. Maria Lantz’s thesis on migraine, PFO and ischaemic stroke forms an important foundation.

We see a very large number of migraine patients and are actively developing our clinical practice to improve migraine care, including preliminary studies into the effects of modern preventive and acute therapies.

We also collaborate closely with Andrea Carmine Belin’s group and the Centre for Cluster Headache on the genetic and biological mechanisms underlying severe headache syndromes.

Small-vessel disease and genetic changes in the white matter

We are studying younger patients with white matter changes, CADASIL and CADASIL-like conditions. Our focus is on identifying genetic and vascular mechanisms to improve diagnosis and risk stratification.

The research is being carried out in collaboration with Professor Urban Lendahl and Associate Professor Helena Karlbom, and Mihae Roland is a postdoctoral researcher on the project.

HISS – Haemorrhagic and Ischaemic Stroke Study

We maintain a stroke database comprising around 8,000 patients from Karolinska Huddinge between 2006 and 2016. It enables studies into risk factors, sources of emboli, treatment outcomes and PFO-related mechanisms.

Publications

All publications from group members

Collaboration

We collaborate with:

We are clinically active and committed to the development of neurovascular care, pre-hospital triage, healthcare environment research and patient-centred outcome measures.